From the ER to the ICU: One Nurse’s Experience

Below, I interview Erin Sullivan, BSN, RN, CEN, about her experiences in critical care. She recently switched her specialty from the emergency nursing to intensive care, and shares her reflections, challenges, and some advice.

What is your background in nursing?

I graduated as a second degree nursing student from George Washington University in 2014. I was a new graduate nurse in the emergency department (ED) for about two years before I switched to the MICU (medical intensive care unit) in March 2016.

When did you decide to change specialty, and why?

I decided to switch to the ICU about 18 months into working in the ED. At the time, I was considering applying to some graduate school programs that required ICU experience as a prerequisite, so I made the switch to broaden my experience and learn a new skill set.

What do you do now and what is your job/where?

I’m working in the MICU at Northwestern Memorial Hospital in Chicago. I also still work per diem in an ED.

What was challenging about the transition to the ICU?

The biggest challenge I had in transitioning from emergency nursing to the ICU was learning how to think like an ICU nurse. There are jokes in nursing that the two types of nurses are “wired differently.” In the ED, the goal is to quickly assess, diagnose, and stabilize patients, and then to move them out to an appropriate level of care as soon as possible. In the ICU, the goals for the patient are more long term, and you have to consider a bigger picture and a larger scope than I would in the ED. It’s a completely different way of thinking, organizing, and prioritizing patient care.

What do you miss most from ER nursing?

The thing I miss most about the ED is the teamwork. I don’t know that I can quite explain the team aspect of ER nursing to someone who’s never experienced it, but there is a special camaraderie that forms between all of your coworkers. Whether it’s one of the best shifts or the worst shift ever, your fellow coworkers join together to make sure we all come out on the other side. I also miss the organized chaos that is the ED, and the anticipation of never knowing what is coming through the door next.

What do you enjoy most about the ICU?

Being in the ICU, I really enjoy being able to watch a patient progress from being critically ill to becoming well enough to leave the unit. Unlike the ED, many times you have a patient three or four shifts in a row, so you can get to know the patients in a way I never got to in the ED.

What do you want to do with your nursing career moving forward?

I’m not sure what the next step is in my career. One of the reasons I chose nursing was because there are so many different options in what you can do. For now, I’m enjoying working in the MICU and picking up in the ED every now and again to get my adrenaline fix. I’m fairly certain though that I’ll find myself back in school pursuing a graduate degree in nursing at some point.

What tips or advice do you have for someone who wants to change their specialty?

My biggest advice for anyone considering switching their specialty is just to do it. As nurses we learn new things everyday, and we shouldn’t be intimidated or scared of the challenges that come with switching specialties!

That said, do your research. Can you handle the stress of a new job right now? Are you adaptable and a quick learner? Do you get along well with new people? These are all considerations before jumping into a new specialty. For me, I was still within the broader scope of critical care. If you’re completely changing specialties, from adults to pediatrics, or from med-surg to labor and delivery, make sure you talk to people who are in that field and that it seems like the right fit for you. But remember, you can always go back!